Pleurodesis
Malignant pleural mesothelioma, along with certain other medical conditions, can cause an accumulation of fluid between the lining of the chest wall (parietal
pleura) and the lining of the lungs (
visceral pleura). The resulting condition is known as
pleural effusion, and
symptoms include shortness of breath (dyspnea) and pain from the pressure of the excess fluid on the body's organs (1).
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is a procedure to
treat pleural effusion. The procedure places a substance (often talc) between the pleural membranes, usually through a large needle or a tube that enters the chest (thoracoscope). The substance irritates the pleural membranes, causing them to become inflamed and stick together. This removes the space between them (the pleural space) so that fluid cannot accumulate. This procedure does not treat the
cancer itself (2, 3).
A pleurodesis can be performed as a bedside procedure or in the operating room, depending on the condition and preferences of the patient. If done as a bedside procedure, it begins with an injection of a local anesthetic. The doctor then inserts a wide needle into the chest, possibly under the guidance of ultrasound. If the procedure is done in the operating room, it is performed via video-assisted thoracoscopy under general anesthetic; the doctor uses the video technology to guide the needle. The tip of the needle is inserted into the space between the membranes where the fluid has accumulated (pleural space). The needle is attached to a drainage tube called a chest drain, which drains the fluid into a bag (3, 4).
The fluid is drained slowly to avoid a drastic reduction in blood pressure. Once the draining is over, the doctor attaches the drainage needle to a talc solution that is sprayed into the pleural space. The drain is clamped in place and left for an hour, after which the doctor may attach the drain to a suctioning device to ensure that the pleura stick together and the pleural space is eliminated (3, 4).